The Austrian Pain Society (ÖSG) not only discussed this little-known problem at a media event on Wednesday. ÖSG President Wilhelm Eisner (MedUni Innsbruck) also recalled the increase in pain due to demographic developments and called on health insurance companies to introduce a second opinion.
The special topic of the International Association for the Study of Pain (IASP) this year is “Gender Pain” and it was chosen for “good reason,” noted Waltraud Stromer from the Horn State Hospital: Women have a higher sensitivity to pain and are more likely to experience it Diseases such as these also have a six times greater chance of becoming chronic. Studies also show that the body’s ability to inhibit pain is less pronounced in women, but depressive symptoms are more common and can act as an amplifier.
Gender-specific behaviors were also found when dealing with pain, said the ÖGS past president: “Women seek help more quickly and receive medication more quickly, men are more inclined to self-medicate,” but aggression or alcohol consumption are often side effects. Undesirable side effects of medication are again the woman’s problem, says Stromer. Accordingly, eight out of ten drugs that were taken off the market because of toxic side effects occurred in women.
Morphine works better in women
The body structure also differs, which in turn is noticeable in the storage of opioids in fatty tissue, and morphine is two to three times more pain-relieving in women than in men. And age also influences the effect, for example Mexalen works longer in old age; doses that are too high carry the risk of liver damage. “In the future, we will have to pay more attention to these differences, both in terms of medication and in terms of multimodal forms of therapy,” summarized Stromer. The motto is to move away from unisex medicine and towards gender-specific treatments.
There are around 1.8 million chronic pain patients in Austria, which would result in around eight billion in total costs annually. This is precisely why there should be a legal right to a second medical opinion. This prevents medical misjudgments, unnecessary interventions and does not force patients to go to a private practice. “It’s about the correct diagnosis so that we can understand how the pain arises,” explained Eisner. As a neurologist, he simply has a different approach than an orthopedist, just as someone who specializes in operations has a different approach than someone who focuses on therapies.
Pain doesn’t have to be a permanent guest
In any case, pain does not have to be a permanent guest, said the head of the University Clinic for Physical Medicine, Rehabilitation and Occupational Medicine at MedUni Vienna, Richard Crevenna. Even with increasing age, aspects that cause illness can be postponed or eliminated through training and exercise. “Over 80 percent of back pain can be treated with physiotherapy and training therapies” – and here the pain often doesn’t come back.
ÖSG General Secretary Rudolf Likar pointed out the impending introduction of ICD-11, the revision of the International Statistical Classification of Diseases, in Austria. For the first time, chronic pain will appear as a separate illness and not be assigned somewhere else. “The diagnosis of ‘chronic pain’ is also important with regard to Long/Post Covid, because the diagnosis of Long/Post Covid pain should be carried out in accordance with pain medicine standards,” says Likar.
ÖSG President Eisner concluded by praising the fact that integrative pain therapy would be anchored in the Austrian Structural Plan for Health (ÖSG). It should be ready by the summer, so the states can then follow suit: “The goal is that there is at least one for each federal state There will be a pain center,” Eisner appealed to politicians.
